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Medical Staff Organization Module Evaluation
Thank you for attending a course accredited by Boston Children’s Hospital, we hope you enjoyed it. All evaluation results are anonymous, and will help provide guidance and feedback to improve future educational offerings from Boston Children’s Hospital. Fields marked with an asterisk are required.
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Course or Module Title
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1. Please identify your profession type:
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Physician (MD/DO)
Nurse
Pharmacist
Physician Assistant
Psychologist
Social Worker
Dentist
Optometrist
Athletic Trainer
Physical Therapist
Dietitian
Other
Please specify:
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3. How would you rate your overall satisfaction with this course?
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Completely dissatisfied
Mostly dissatisfied
Somewhat dissatisfied
Neutral
Somewhat satisfied
Mostly satisfied
Completely satisfied
4. Will you make clinical, teaching, research or administrative changes as a result of engaging in this course?
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Yes, please specify
No
What changes will you make?
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5. If you will not make changes as a result of taking this course, why not?
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Current practice is satisfactory
I disagreed with recommendations made
Lack of time
Lack of resources
Lack of support for change by administration
Costs
Patient barriers
Other
Please specify barriers to makeing clinical, teaching, research or administrative changes:
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Please indicate the degree to which you agree or disagree with the following statements:
Likert Scale
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Strongly Disagree
Disagree
Somewhat Disagree
Neutral
Somewhat Agree
Agree
Strongly Agree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice.
Strongly Disagree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Strongly Disagree
Disagree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Disagree
Somewhat Disagree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Somewhat Disagree
Neutral
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Neutral
Somewhat Agree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Somewhat Agree
Agree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Agree
Strongly Agree
6. The educational activity helped to address, overcome, or remove barriers to change in my professional practice. Strongly Agree
7. Were all of the identified course objectives met? (See module page for learning objectives)
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Yes
No, please specify:
Which objectives were not met?
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8. Please include any presentation or speaker specific feedback related to this course here:
10. Do you have suggestions for future educational courses?
Name
Submit